Welcome to my blog. HIV prevalence is not a reliable indicator of sexual behavior because the virus is also transmitted through unsafe healthcare, unsafe cosmetic practices and various traditional practices. This is why many HIV interventions, most of which concentrate entirely on sexual behavior, have been so unsuccessful.

Thursday, March 19, 2009

Why is abstinence not proposed as a strategy to reduce alcohol or drug dependency? How about obesity as a result of overeating? Perhaps it’s because if those with a dependency could abstain, they wouldn’t have a dependency. Ok, some people manage to give up drugs, alcohol or overeating. That takes a lot of work and a lot of help and support. Some succeed and some don’t.

Why is abstinence not proposed as a strategy to reduce crime? Instead of having laws, why not just have a campaign to get potential criminals to vow to abstain from crime? They should know that crime is wrong and that they will be punished if they are caught. I think the answer is obvious.

But a certain Mr Pope, a man without an electoral mandate or, indeed, without any experience of sexual intercourse or sexual relationships, thinks that abstinence is the only way to avoid HIV. Well, Mr Pope, you’re quite wrong. In Nyanza province in Kenya, women are more likely to contract HIV from their husbands. Husbands also contract HIV from their wives.

Yes, both parties should abstain, of course. Everyone ‘should’ abstain, but abstinence does not protect anyone from sexual desire. One party in a relationship abstaining does not ensure that the other party also abstains.

Abstinence is an individual decision but most sexual relationships require more than one person. The issue is not about individual duties and responsibilities but rather the duties and responsibilities of people who live in close contact with other people. Each person’s life is to a large extent determined by external influences. Human behaviour and sexual desire do not arise in individuals in isolation, they arise in individuals living with other individuals.

Those external (or non individual) influences determine many things, including when, where, how often and with whom people have sexual relationships. An individual’s decision to abstain doesn’t protect them from HIV because their HIV status is also influenced by factors external to them.

As for the individual decision to abstain, well, I certainly don’t decide to do things that would put me in danger. I am fairly risk averse, I don’t enjoy pain or dangerous activities. But just as the absence of safe water and food supply would not make me any less thirsty or hungry, the relative dangers of sleeping with another person would not decrease the sexual desire I may feel.

If a person doesn’t feel much sexual desire or their desire is outweighed by other considerations, there may be no problem. If they get to decide whether to have sex and with whom, great, they are lucky. But there are many people who are not in that position, for one reason or another. Even in the Catholic Church, people are often in positions where they will have sex, whether they choose to or not.

Abstinence does not guarantee against harm because an individual decision to abstain from sex does not preclude something arising to override that decision. Nor does it guarantee that others will respect the individual decision to abstain.

But, quite frankly, I don’t want to abstain. I think that I have a right to have consensual sex with another adult. I don’t think Mr Pope agrees, but I just don’t subscribe to his views. I don’t feel the need to repress my sexual desire in order to follow his blind dogma. And I know that the absence of the opportunity to engage in sexual activity does not result in sexual desire just disappearing.

So if abstinence is not always going to work, what other options for harm reduction are there? Condoms sound like an obvious harm reduction strategy against sexually transmitted infections. Mr Pope advocates against using condoms because it is ‘wrong’. But Mr Pope and his adherents have defended many things that would also be considered wrong, so I don’t really see where his authority comes from.

Actually, that’s where my argument becomes seriously unstuck. Millions of Africans (and other people around the world) invest authority in Mr Pope and his acolytes. In Kenya and Tanzania, people constantly talk about Jesus, God, their religion, the bible, various quotations and proverbs and titbits of ‘knowledge’ from religious sources.

Mr Pope speaks for millions of people because they pay millions of pounds to support him and his religious prognostications. But beware, Mr Pope, you have many followers who go to your churches and contribute towards the obscene amounts of money you receive, but they don’t abstain. HIV rates are usually higher among those claiming to be Christian than among other religious groups.

I don’t see why Mr Pope’s religious teachings should have such a profound bearing on public health. He clearly knows nothing about public health, but that’s understandable. What I find difficult to understand is his lack of understanding about human behaviour. Even if he doesn’t feel sexual desire or if he feels it’s something he should deal with in other ways than sexual behaviour, why does he think that everyone else should feel the same way. Why does he think that others are able to behave as he does?

Mr Pope, whether you want to hear it or not; abstinence as a strategy does not work. Even if you are not interested in the many studies carried out that show that abstinence as a strategy does not work, you must be able to see that millions of your followers are infected with HIV and millions more will become infected.

I stand to be corrected on this but I think suicide is also considered wrong in the Catholic faith? Is a strategy that is known to fail to protect against HIV not suicidal? By preaching against the use of condoms and advocating abstinence, are you not in danger of increasing what is effectively suicidal behaviour, Mr Pope?

6 comments:

Abstinence, the word that solves any problem, without having to refer to anything sticky, like why some things are hard to achieve. Today I shall abstain from procrastination and work hard. At the weekend I shall abstain from worry and have a fun and relaxing time. Simple.